Dr.Vijayamohan.S, AIMS,Kochi

The team

2 orthopedic surgeons

2 plastic surgeons

2 maxillofacial surgeons

2 anesthetists

1 infectiologist

54 M

20 F

395

74

74

18

74

60

Poly trauma

Plastic reconstruction

Extensive debridement

External fixation

Antibiotics based on bone culture

Plastic intervention

Nutritional care

Internal fixation / Bone grafting

Rehabilitation

Amikacine

Gentamycine

Cloxacilline

Levofloxacinne

Ofloxacine

Clindamycine

Ceftrioxone

Imipenem

Tazocilline

Vancomycine

Continuous IV

15mg/kg 1hr

30mg/kg/dayVancomycine

Continuous IV6gCeftazidime

IV150 mg/KgCloxacilline

IV /IM2gCceftrioxone

IV only200mg/KgAmoxicilline

Posology

68

62 Internal fixationamputation

Ex.fix / pop

Debridement is the keyDon’t save skin, go for flap

Don’t avoid scar, go for flap

Antibiotics as per bone culturePus cultures may be misleading

Combination in MultiRh cases

Ex Fix as a definitive tool

Nutrition and rehabilitation